Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension

Douglas M. Coldwell, Ernest J. Ring, Chet R. Rees, Gerald Zemel, Michael D. Darcy, Ziv J. Haskal, Michael A. McKusick, Alan J. Greenfield

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

PURPOSE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) placement, a prospective multicenter trial was undertaken. MATERIALS AND METHODS: In eight institutions, 96 patients underwent TIPS placement after fared sclerotherapy (Child-Pugh class A [n = 24], class B [n = 38], and class C [n = 34]), with follow-up for 6 months (with ultrasonography and angiography and clinical and laboratory studies). RESULTS: TIPS placement was successful in all patients (mean initial portosystemic pressure gradient, 22.8 mm Hg + 6.7 [standard deviation]; mean decrease after placement, 12.8 mm Hg + 5.2), with variceal embolization in 25 patients. Complications included liver capsule puncture (n = 12), hepatic artery puncture (n = 3), main portal vein puncture (n = 1), and increased encephalopathy (n = 28). The 30-day mortality rate was 0% for patients with Child class A disease, 18% for class B, and 40% for class C. At 6 months, primary patency was 88% and assisted patency was 94%. CONCLUSION: The risk associated with TIPS placement is reasonable, and it is an effective procedure for the treatment of portal hypertension.

Original languageEnglish (US)
Pages (from-to)335-340
Number of pages6
JournalRadiology
Volume196
Issue number2
StatePublished - Aug 1995

Fingerprint

Transjugular Intrahepatic Portasystemic Shunt
Portal Hypertension
Punctures
Sclerotherapy
Hepatic Artery
Brain Diseases
Portal Vein
Multicenter Studies
Capsules
Ultrasonography
Angiography
Safety
Pressure
Mortality
Liver

Keywords

  • Hypertension, portal
  • Liver, cirrhosis
  • Liver, interventional procedure
  • Shunts, portosystemic

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Coldwell, D. M., Ring, E. J., Rees, C. R., Zemel, G., Darcy, M. D., Haskal, Z. J., ... Greenfield, A. J. (1995). Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension. Radiology, 196(2), 335-340.

Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension. / Coldwell, Douglas M.; Ring, Ernest J.; Rees, Chet R.; Zemel, Gerald; Darcy, Michael D.; Haskal, Ziv J.; McKusick, Michael A.; Greenfield, Alan J.

In: Radiology, Vol. 196, No. 2, 08.1995, p. 335-340.

Research output: Contribution to journalArticle

Coldwell, DM, Ring, EJ, Rees, CR, Zemel, G, Darcy, MD, Haskal, ZJ, McKusick, MA & Greenfield, AJ 1995, 'Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension', Radiology, vol. 196, no. 2, pp. 335-340.
Coldwell DM, Ring EJ, Rees CR, Zemel G, Darcy MD, Haskal ZJ et al. Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension. Radiology. 1995 Aug;196(2):335-340.
Coldwell, Douglas M. ; Ring, Ernest J. ; Rees, Chet R. ; Zemel, Gerald ; Darcy, Michael D. ; Haskal, Ziv J. ; McKusick, Michael A. ; Greenfield, Alan J. / Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension. In: Radiology. 1995 ; Vol. 196, No. 2. pp. 335-340.
@article{ba8b4d8cb07c4fb8980e6eebcd181990,
title = "Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension",
abstract = "PURPOSE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) placement, a prospective multicenter trial was undertaken. MATERIALS AND METHODS: In eight institutions, 96 patients underwent TIPS placement after fared sclerotherapy (Child-Pugh class A [n = 24], class B [n = 38], and class C [n = 34]), with follow-up for 6 months (with ultrasonography and angiography and clinical and laboratory studies). RESULTS: TIPS placement was successful in all patients (mean initial portosystemic pressure gradient, 22.8 mm Hg + 6.7 [standard deviation]; mean decrease after placement, 12.8 mm Hg + 5.2), with variceal embolization in 25 patients. Complications included liver capsule puncture (n = 12), hepatic artery puncture (n = 3), main portal vein puncture (n = 1), and increased encephalopathy (n = 28). The 30-day mortality rate was 0{\%} for patients with Child class A disease, 18{\%} for class B, and 40{\%} for class C. At 6 months, primary patency was 88{\%} and assisted patency was 94{\%}. CONCLUSION: The risk associated with TIPS placement is reasonable, and it is an effective procedure for the treatment of portal hypertension.",
keywords = "Hypertension, portal, Liver, cirrhosis, Liver, interventional procedure, Shunts, portosystemic",
author = "Coldwell, {Douglas M.} and Ring, {Ernest J.} and Rees, {Chet R.} and Gerald Zemel and Darcy, {Michael D.} and Haskal, {Ziv J.} and McKusick, {Michael A.} and Greenfield, {Alan J.}",
year = "1995",
month = "8",
language = "English (US)",
volume = "196",
pages = "335--340",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Multicenter investigation of the role of transjugular intrahepatic portosystemic shunt in management of portal hypertension

AU - Coldwell, Douglas M.

AU - Ring, Ernest J.

AU - Rees, Chet R.

AU - Zemel, Gerald

AU - Darcy, Michael D.

AU - Haskal, Ziv J.

AU - McKusick, Michael A.

AU - Greenfield, Alan J.

PY - 1995/8

Y1 - 1995/8

N2 - PURPOSE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) placement, a prospective multicenter trial was undertaken. MATERIALS AND METHODS: In eight institutions, 96 patients underwent TIPS placement after fared sclerotherapy (Child-Pugh class A [n = 24], class B [n = 38], and class C [n = 34]), with follow-up for 6 months (with ultrasonography and angiography and clinical and laboratory studies). RESULTS: TIPS placement was successful in all patients (mean initial portosystemic pressure gradient, 22.8 mm Hg + 6.7 [standard deviation]; mean decrease after placement, 12.8 mm Hg + 5.2), with variceal embolization in 25 patients. Complications included liver capsule puncture (n = 12), hepatic artery puncture (n = 3), main portal vein puncture (n = 1), and increased encephalopathy (n = 28). The 30-day mortality rate was 0% for patients with Child class A disease, 18% for class B, and 40% for class C. At 6 months, primary patency was 88% and assisted patency was 94%. CONCLUSION: The risk associated with TIPS placement is reasonable, and it is an effective procedure for the treatment of portal hypertension.

AB - PURPOSE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) placement, a prospective multicenter trial was undertaken. MATERIALS AND METHODS: In eight institutions, 96 patients underwent TIPS placement after fared sclerotherapy (Child-Pugh class A [n = 24], class B [n = 38], and class C [n = 34]), with follow-up for 6 months (with ultrasonography and angiography and clinical and laboratory studies). RESULTS: TIPS placement was successful in all patients (mean initial portosystemic pressure gradient, 22.8 mm Hg + 6.7 [standard deviation]; mean decrease after placement, 12.8 mm Hg + 5.2), with variceal embolization in 25 patients. Complications included liver capsule puncture (n = 12), hepatic artery puncture (n = 3), main portal vein puncture (n = 1), and increased encephalopathy (n = 28). The 30-day mortality rate was 0% for patients with Child class A disease, 18% for class B, and 40% for class C. At 6 months, primary patency was 88% and assisted patency was 94%. CONCLUSION: The risk associated with TIPS placement is reasonable, and it is an effective procedure for the treatment of portal hypertension.

KW - Hypertension, portal

KW - Liver, cirrhosis

KW - Liver, interventional procedure

KW - Shunts, portosystemic

UR - http://www.scopus.com/inward/record.url?scp=0029082293&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029082293&partnerID=8YFLogxK

M3 - Article

C2 - 7617842

AN - SCOPUS:0029082293

VL - 196

SP - 335

EP - 340

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -